Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 00023691 | AL |
Y | 207V00000X | Obstetrician & Gynecologist | 13911 | MS |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 00023691 | AL |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 13911 | MS |
N | 207VG0400X | Gynecologist | 00023691 | AL |
N | 207VG0400X | Gynecologist | 13911 | MS |
N | 208800000X | Urologist | 00023691 | AL |
N | 208800000X | Urologist | 13911 | MS |
NPI | 1790722999 |
---|---|
Provider Name | Dr. Steven Edwin Speights |
First Address | Jackson, MS 39202-1651 |
Second Address | Jackson, MS 39202-1651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 20/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0121092 | (05) | MS |
160046013 | RAILROAD MEDICARE (01) | MS |
5850547 | AETNA (01) | MS |
G47854 | (02) | MS |